Paediatrics

Slipped Upper Femoral Epiphysis

Slipped upper femoral epiphysis (SUFE/SCFE) is displacement through the proximal femoral growth plate, usually around adolescence; suspected disease requires non-weight-bearing and urgent paediatric orthopaedic stabilisation.

Definition

Slipped upper femoral epiphysis is displacement of the proximal femoral epiphysis relative to the metaphysis through the growth plate, usually during adolescence. It is clinically classified as stable or unstable according to whether the child can weight-bear.

First principles

The epiphysis stays in the socket while the neck displaces

The femoral head remains seated in the acetabulum while the femoral neck and metaphysis move relative to it through a weakened proximal femoral physis, usually posteriorly and inferiorly. This produces external rotation and loss of internal rotation on examination.

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